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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of acute renal failure complicating multiple myeloma are reported. In both, the renal failure preceded the diagnosis of multiple myeloma. In one case oliguria occurred after performance of a venogram; renal function returned to normal after two weeks of intermittent peritoneal dialysis, emphasizing the reversibility of the renal failure in some cases.
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PMID:Acute renal failure in multiple myeloma. 485 Apr 22

Eight patients presented with simultaneous multiple myeloma and acute renal failure requiring hemodialysis. Patients had no known pre-existing renal disease nor exposure to nephrotoxic agents or x-ray contrast dye. Renal failure was attributed to light chain nephropathy in all cases. In 4 of these patients the diagnosis of myeloma was initially unsuspected. Renal biopsies in 3 of these patients, and post-mortem material in a fourth revealed the changes of "myeloma kidney." No patient regained renal function and all required chronic hemodialysis. Among these eight patients, three survived for periods greater than 21 months.
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PMID:Long-term survival of patients with multiple myeloma and acute renal failure at presentation. 640 26

In a study of renal function in multiple myeloma seven patients presented with renal failure and three developed it 16-106 months after diagnosis. All were dialysed. Infection with dehydration was a precipitating factor in all seven cases of acute or acute on chronic renal failure. Of these, two patients recovered normal renal function and one other was left with permanent renal impairment but no longer required dialysis. Results from the seven patients with acute renal failure and for the three with more chronic features support the practice of dialysis for all patients who present with renal failure. Dialysis is not indicated for those patients with progressive myelomatous disease. The study showed no evidence that chemotherapy permitted recovery from established renal failure. The prognosis in this elderly group is heavily dependent on the presence of cardiovascular or other degenerative disease.
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PMID:Should patients with renal failure associated with myeloma be dialysed? 641 9

A case of acute renal failure secondary to bilateral renal vein occlusion by a retroperitoneal plasmacytoma is described. The use of low-risk radiographic techniques including radionuclide venography and a computerized axial tomography (CAT) scan made a rapid and accurate diagnosis possible. Fatal hemorrhage occurred following tumor erosion and perforation of the vena cava. In patients with multiple myeloma, and clinically apparent retroperitoneal tumor, vascular compromise should be considered in the differential diagnosis of acute renal insufficiency.
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PMID:Acute renal failure secondary to vascular occlusion by a retroperitoneal plasmacytoma. 669 10

In the past, patients with multiple myeloma and acute renal failure have had a poor prognosis. Few patients recovered renal function and fewer still survived for prolonged time periods. This report describes the course of 10 patients with multiple myeloma and true acute renal failure treated during the decade 1970 to 1980, and reviews recent reports concerning this association. The use of radiographic contrast agents is no longer the primary predisposing factor to acute renal failure in the myeloma population. Rather, infection, hypercalcemia, and dehydration in the presence of light chain excretion are the major conditions precipitating the renal failure. Despite severe renal failure requiring dialysis, many patients may regain good renal function. Factors associated with a good or poor prognosis in this population are reviewed. The prognosis in patients with myeloma and acute renal failure has greatly improved in recent years, and prolonged survival may occur.
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PMID:Acute renal failure in patients with multiple myeloma. 669 48

Numerous reports refer to the development of acute renal failure following intravenous urography in patients with multiple myeloma, while other authors consider the risk to be acceptable if abdominal compression and dehydration are avoided and alkalization of urine is carried out. The outcome of 34 intravenous urographies with Conray 70, Conray FL, and Conray 36 has been evaluated in 26 patients with multiple myeloma. No case of acute renal failure was observed. Two patients experienced a mild increase (greater than 0.3 mg/dl) in serum creatinine levels. Mean value of serum creatinine was 1.28 mg/dl prior to and 1.18 mg/dl after urography. In three of four patients with preexisting azotemia serum creatinine levels fell after urography, while in the fourth a mild increase from 2.0 mg/dl to 2.5 mg/dl five days after the examination was observed. Data from the literature in addition to own data are presented. From all the data taken together we conclude that intravenous urography may carry a moderately increased risk of acute renal failure in patients with multiple myeloma. It may be performed if the indication is well established.
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PMID:[Problems of intravenous urography in patients with plasmocytoma]. 684 2

Severe renal insufficiency is considered to indicate a poor prognosis in patients with multiple myeloma, their reported median survival being approximately 2 months. In five consecutive patients with severe renal failure secondary to acute myeloma kidney early aggressive therapy, including chemotherapy and peritoneal dialysis, led to a significant improvement in the renal function of four; the fifth patient received a cadaveric renal transplant after 1 year of peritoneal dialysis. After a median follow-up period of 12 months all the patients were alive and had improved renal function. This experience contrasts with that previously reported and suggests that aggressive management may improve the survival of patients with acute renal failure due to myeloma kidney.
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PMID:Treatment of acute renal failure due to myeloma kidney. 700 18

A 65-year-old woman with polyclonal hypergammaglobulinemia developed acute renal failure requiring hemodialysis after an intravenous pyelogram (IVP). An increased risk of renal injury after IVP for patients with polyclonal hypergammaglobulinemia has not been previously recognized, although a parallel risk to patients with myeloma has been well established. At autopsy, immunoperoxidase staining of the bone marrow demonstrated plasma cell subpopulations with intracellular staining for IgG, IgA, and IgM and chi and lambda light chains, proving that this patient did not have occult myeloma. Immunoperoxidase staining of casts in renal tubules also demonstrated polyclonal immunoglobulins.
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PMID:Acute renal failure following intravenous pyelography (IVP) in a patient with diffuse hypergammaglobulinemia: a case report. 704 16

The types of renal disease that are particularly common in the elderly include acute renal failure, prerenal azotemia, multiple myeloma kidney, and obstruction. Hemodialysis and peritoneal dialysis, now proven effective in controlling renal disease in older patients, require special considerations when applied to the elderly patient.
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PMID:Renal disease in the elderly. 707 79

Four patients with acute renal failure due to myeloma (IgG with lambda, lambda, lambda, IgG with kappa) were studied; serum creatinine was 4.7, 5.9, 4.25, 10.8 mg%, and proteinuria 2.1, 2.8, 5.2, 4.2g/24h respectively. Renal biopsy specimens (3 patients) showed interstitial fibrosis, oedema, infiltration of mononuclear cells, tubular atrophy or dilatation with many 'myeloma kidney' casts. The patients were treated with plasmapheresis (2-4 exchanges) and methylprednisolone pulses (three to four 1g pulses). Maintenance therapy included prednisone, vincristine, melphalan and cyclophosphamide. After a follow up of 26, 17, 8, 6 months respectively, serum creatinine levels are 1.7, 2.4, 1.8, 4.2mg% respectively. Proteinuria disappeared after three months of therapy in 3 patients, and then remained absent for the successive follow up.
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PMID:Steroid pulses and plasmapheresis in the treatment of acute renal failure in multiple myeloma. 724 8


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